A few months ago AHRQ released their “Interim Update on 2013 Annual Hospital-Acquired Condition Rate and Estimates of Cost Savings and Deaths Averted From 2010 to 2013.” This report indicated there were 1.3 million fewer patient events between 2010 and 2013 around the 27 hospital-acquired conditions (HAC) that were tracked. Of these, hospital-acquired infections (HAIs) made up about 30%. Over the past five years, I have watched hospitals, under the leadership of many dedicated infection preventionists, drive down the rates of HAIs. Not long ago these events were considered an unavoidable part of medical care, now there are campaigns waving the flag of “Targeting Zero” that seek to eliminate avoidable infections.
This is where I want to turn the attention to my pharmacy colleagues. Of those 27 HACs, 33% (around 9 measures) were medication-related, including adverse events to anticoagulants (LWMH, warfarin), hypoglycemics, contrast media and antibiotic-associated C. difficile infections. Could pharmacists, as the medication experts, take the necessary leadership role to stamp out avoidable ADEs with the collective effort and enthusiasm that the infection preventionists have mustered?
I would say the current environment around medication safety and ADE/HAC reduction offers an excellent opportunity for pharmacists. First, clearly the main reason to reduce ADEs is to protect patients, but HAC rates also represent penalties to your organization. CMS’ new HAC program started in October 2014, and hospitals in the worst performing quartile will be fined up to 1% of their total Medicare annual payment.
It is also worth noting that, with all the focus on avoidable readmissions and admissions, ADEs represent one of the main causes for both relative to commonly targeted culprits such as heart failure and AMI. We also know that ADEs have a tremendous impact on cost and length of hospitalization.
So let me repeat my call to action: Let’s rise up, pharmacists, and take the lead on this opportunity to improve patient safety. Technology that can help quickly and efficiently identify patient at potential risk for ADEs is available to assist us in this effort and the mounting regulatory pressure can help us in gaining the administrative support necessary to move forward.
About the Author
Steven M Riddle, PharmD, BCPS, FASHP serves as Director of Clinical Development for Pharmacy OneSource/Wolters Kluwer Health; a company that provides web-based technology solutions and evidence-based content to support optimal quality in point-of-care delivery of health services. Steve is responsible for overall strategic direction around clinical content and determination of business opportunities for Pharmacy OneSource. Steve also serves as the Director for the Fellowship Program and as liaison for the company to the healthcare profession.
Dr. Riddle has 30 years’ experience in healthcare, including inpatient and ambulatory clinical services, pharmacy administration and quality improvement. Steve received his Bachelor of Pharmacy from Washington State University and his Doctorate of Pharmacy from the University of Washington. He is currently a Clinical Affiliate Professor at the UW School of Pharmacy and serves on the Washington State University College of Pharmacy Dean’s Advisory Council. Steve’s specific professional interests are quality improvement, health care system reform, population management and wellness-centered healthcare.
Dr. Riddle recently completed his 3-year service as the Chair for the Section of Ambulatory Care Practitioners for the American Society of Health-Systems Pharmacists (ASHP). He current serves ASHP on the Center on Pharmacy Practice Advancement Advisory Committee, the Ambulatory Care PPMI Committee and the PAC and Advocacy Advisory Committee, the. He is currently serves on the Quality Metrics Expert Panel for the Pharmacy Quality Alliance (PQA). Steve served for 3 years as inaugural Chair for the Washington State Pharmacy Association’s Health Systems Academy. He is a member of ASHP, the American College of Clinical Pharmacists (ACCP) and the Washington State Pharmacy Association (WSPA) and supports these association’s goals of integrating and expanding pharmacy practice to improve patient care. Steve was named a Fellow of ASHP in 2009 and has received distinguished leadership awards from ASHP and WPSA.